Seventh Circuit remands inmate’s pro se lawsuit over pain medication management for trial

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The Seventh Circuit Court of Appeals is remanding for trial a Wisconsin inmate’s pro se lawsuit over his pain medication management. The judges found the Western District of Wisconsin court was wrong to grant summary judgment to a nurse who could be found deliberately indifferent to the inmate’s suffering.

The Seventh Circuit released its opinion on Anthony Machicote’s appeal on Friday. Machicote, a Wisconsin inmate, had surgery on his left ankle after he was hurt playing basketball in the New Lisbon prison yard. After the surgery, Machicote received oxycodone and was told he’d be in “extreme pain” when it wore off. He was discharged with instructions recommending he take narcotic-strength painkillers every six hours.

At the prison, a doctor ordered Tylenol #3, a combination of acetaminophen and codeine, for Machicote to take every six hours for three days. That night, a nurse told him to take his first dose of the Tylenol at 9:30 p.m., but Machicote refused, saying he was worried it would wear off before the morning and that it had been less than six hours since he took the oxycodone.

According to court documents, the nurse said she “did not care” and said Machicote would have to “deal with the pain” if he didn’t take the Tylenol right away because the medication wouldn’t be available again until the morning.

Machicote took the pills at 9:30 p.m. and woke up at 3:30 a.m. in “excruciating pain.” He said he laid awake in pain until the nurse returned with more Tylenol around 6:20 a.m.

The nurse attempted to align Machicote’s dosages with the prison’s distribution schedule, which did not comply with the surgeon’s recommendation. Machicote said he was in pain throughout the night because of the revised schedule.

After the doctor’s medication order ran out, Machicote started having ankle pain around the clock and told the nurse. Court documents say the nurse refused to call a doctor, and that Machicote’s friends had to make several requests and phone calls to have him seen. Five days after his initial medication order expired, a doctor prescribed him another painkiller. He did not receive the medication for two more days, and he needed pain management for several more weeks.

Without help from an attorney, Machicote sued the doctors, health services manager and nurse under 42 U.S.C. § 1983, claiming that they were deliberately indifferent to his post-surgery pain in violation of the Eighth Amendment.

He requested a lawyer be recruited to help him, but the district court denied the request, saying he needed to try to find a lawyer on his own.

The defendants moved for summary judgment and were successful. The district court concluded Machicote had no evidence showing the defendants were deliberately indifferent to his suffering. The district court entered judgment in favor of the defendants.

Machicote, again without a lawyer, appealed the grant of summary judgment and denial of his request for recruited counsel. The case went before Seventh Circuit Court of Appeals Judges Kenneth Ripple, David Hamilton and Michael Scudder.

On Friday, the judges affirmed judgments in favor of the doctors and health-services manager, but vacated the judgment for the nurse and remanded the case for a trial.

The judges said Machicote persuaded them that a factual issue remains concerning the deliberate indifference of the nurse. The opinion cited three incidents that could convince a jury that the nurse had deliberately ignored Machicote’s pain: the nurse’s defiance of the doctor’s order on the first night, the changed dosage schedule and the refusal to consult a doctor when the pain medication ran out.

“That is not to say a jury could not come to the opposite conclusion or credit Nurse Stecker’s side of the story,” Scudder wrote in the opinion. “Those decisions rest in the jurors’ hands in the first instance. We hold only that Machicote is entitled to the opportunity to make his case at a trial.”

The appellate court also reviewed the denial of Machicote’s request for counsel for an abuse of discretion, and they found none.

“As the district court explained, Machicote had not made sufficient efforts to find a lawyer on his own, and he appeared to be competent to litigate the case himself at that early stage,” Scudder wrote.

The judges commended Machicote on the quality of his filings, but said they weren’t suggesting he wouldn’t benefit from an attorney’s help. Machicote may renew his request for recruited counsel on remand. Follow @natebeck9